Background to this inspection
Updated
16 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was undertaken by two inspectors and an inspection manager. On day one, an inspector and an assistant inspector conducted the inspection. On day two, an inspector and an inspection manager conducted the inspection.
Service and service type
Asher House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection took place on 10 and 15 October 2019 and was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and external professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection. We used all this information to plan our inspection.
During the inspection-
We spoke with four people who used the service and four relatives about their experience of the care provided. We spoke with eight members of staff including the provider, registered manager, senior care, care workers and the cook.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.
Updated
16 November 2019
About the service
Asher House is registered to support up to 20 older people, some of whom may be living with dementia. At the time of our inspection, 13 people were being supported at the service.
Asher House provides accommodation on two floors with access via a stair lift. It is situated in a quiet residential area in Walton on the Naze.
People’s experience of using this service and what we found.
The provider failed to safely maintain the environment to ensure it was safe for people living in the service. Appropriate checks were not in place by competent staff to ensure the environment was safe.
People's medicines were not managed safely.
People’s risk assessments were not updated in line with their current needs and risks. Where people had additional physical and mental health needs, care plans did not always inform staff how to manage these well.
Mental capacity assessments were not always completed where capacity was questioned.
Staff had not received training in how to support people living with dementia, despite of some people living with this diagnosis. We made a recommendation about this.
The environment of the home had not been adapted to ensure that it met with the needs of people living with dementia.
We made a recommendation about this.
Staff were instinctively caring but did not always have the skills and knowledge to undertake their role.
Care plans were not reflective of people’s current needs and did not reflect support they required.
The service did provide meaningful activities for people.
End of life care plans were not always in place for people. We have recommended end of life care planning for people to be developed further.
The service was not well led. Systems were in place to monitor the quality of the service; however, these were not effective and failed to highlight concerns raised during the inspection.
The provider had failed to put systems in place to support the registered manager to have oversight the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (report published 2 October 2018).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will act in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.